Darcy Ummels

124 | Chapter 6 Figure 6.4 Flowchart on how to use activity trackers in daily clinical practice in the final version of the manual. Blue, starting or stopping point for using the activity tracker; yellow, assessment period; green, intervention period. Increase physical activity: to increase the daily step count or daily active minutes per day; decrease physical activity: to decrease the daily step count or daily active minutes per day; divide physical activity: to remain the same amount of steps or active minutes per day but divide the physical activity moments equally over the day. Instruction Therapists introduced the activity tracker to all participating patients and told them they wanted to assess their physical activity level. They explained why they thought an activity tracker could be beneficial and why they would prefer an objective measurement of the physical activity level. During the first reflection session, therapists decided to adapt the instruction; they explicitly told patients not to change their physical activity level and explained why the assessment period had value to therapists and patients as a baseline and for the intervention period. Furthermore, from the second iteration on, the therapists added more explicitly that after the assessment period, an intervention and an evaluation period would follow. “With this activity tracker, we can objectively measure how active you are. The activity tracker will show us your actual physical activity level.” ‐ Explanation from therapist 2 to patient 3 during a therapy session (audiotaped conversation). After the instruction, the therapists installed the activity tracker together with the patients. Therapists either performed the entire installation (e.g., downloading and synchronizing the app) or verbally explained step ‐ by ‐ step what patients needed to do based on the technical skills of the patient. After the application was installed, the therapist explained the user interfacee to the patients by showing them how it worked. They did not change this explanation during the iterations.